Individual provider Active NPI

Derek Dewig, LAT, ATC

  • Athletic Trainer
  • Chapel Hill, NC
National Provider Identifier
1336535756
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
LAT-2488 Issued in NC
Practice address
419 Thornwood Rd
Chapel Hill, NC 27517-2334
Phone
(812) 223-1599
NPI assigned
Apr 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X LAT-2488 NC Primary

Addresses

Primary practice location

419 Thornwood Rd
Chapel Hill, NC 27517-2334

Mailing address

3719 Oak Hill Rd
Evansville, IN 47711-2939
Phone (812) 223-1599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LAT-2488NCMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1336535756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 OAK HILL RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477112939",
            "telephone_number": "812-223-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 THORNWOOD RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172334",
            "telephone_number": "812-223-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWIG",
        "first_name": "DEREK",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-2488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.